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Peripheral Arterial Disease Often Under-Diagnosed and Under-Treated

separator Peripheral arterial disease (PAD) is a fairly common condition. It affects an estimated 8 to 10 million people in the United States, and it puts people at a high risk of heart attack, stroke and death. Treatment is often quite simple, but a recent study published in the Journal of the American Medical Association (JAMA) has pointed out that PAD is frequently under-diagnosed, leaving people at high risk unnecessarily. This is especially important news for people with diabetes, who are at higher risk of PAD than the general population.

PAD is a form of atherosclerosis, a hardening or narrowing of the arteries caused by the buildup of plaque. This plaque buildup slows down blood flow, increasing the risk of heart attack and stroke. You may have heard about this type of narrowing in the arteries of the heart, which is called coronary artery disease. PAD is the same type of condition, but it occurs in the arteries of the arms, kidneys, legs and feet.

What are the Symptoms?
The main symptom of PAD is leg pain or weakness. At first, you might feel pain only during physical activity, such as walking. In its later stages, PAD can become much more severe, causing disability.

People often mistake their leg pain as simply a normal part of aging, but this is not the case. Most people can control their symptoms if their PAD is diagnosed and treated.

Other, less common symptoms include:

  • High blood pressure
  • Kidney failure
  • Abdominal pain and vomiting
  • Dry skin
  • Sores on the feet and lower legs

Who's at Increased Risk?
The following factors increase the risk of PAD:

  • History of smoking
  • Diabetes
  • High cholesterol
  • High blood pressure

PAD is most commonly diagnosed using a painless measurement called the ankle-brachial index. Blood pressure is measured in the arm and then the ankle. A simple calculation determines whether PAD is present.

PAD Treatment: Readily Available
The JAMA study comprised 6,979 patients aged 70 or older or patients 50 through 69 years old with a history of smoking or diabetes. Results of the study, which were published in September, revealed that PAD is often under-diagnosed. Additionally, even when study participants had been diagnosed with PAD, they were not as likely to be treated for it as people who have cardiovascular disease.

Anti-platelet medication is the most common treatment for PAD. For some people, this may simply mean taking aspirin every day. For others, a prescription medication may be more effective. The Food and Drug Administration has approved the use of a drug called clopidogrel for prevention of heart attack in patients with PAD. Other treatment may involve regular exercise and an adjustment in eating habits.

If you have diabetes, consider discussing your risk of PAD with your doctor. Treatment is fairly simple for most people, and can significantly reduce your risk of heart attack and stroke.

Journal of the American Medical Association, 19 September 2001; New England Journal of Medicine, 24 May 2001.
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